Exam (elaborations)
THE NURSING PROCESS QUESTIONS WITH ANSWERS .
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THE NURSING PROCESS QUESTIONS WITH ANSWERS .
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THE NURSING PROCESS QUESTIONS WITHANSWERS .
The,nurse,is,documenting,in,the,client's,health,record.,Which,information,is,most,appropriate,for,the,nurs
e,to,record,as,objective,data?,Select,all,that,apply.
,a),Client's,blood,pressure,is,120/80,mm,Hg;,pulse,76,bpm;,respirations,14,breaths/min.
,b),Client's,dressing,is,intact,with,scant,amount,of,serous,drainage.
,c),Client,ambulated,to,end,of,hallway.
,d),Client,seems,to,be,very,depressed.
,e),Client,appeared,angry,and,belligerent,all,shift.,ANS,-
A.,Client's,blood,pressure,is,120/80,mm,Hg;,pulse,76,bpm;,respirations,14,breaths/min.
B.,Client's,dressing,is,intact,with,scant,amount,of,serous,drainage.
C.,Client,ambulated,to,end,of,hallway.
Client,vital,signs,,observation,of,a,dressing,,and,documentation,of,the,activity,of,a,patient,represent,objec
tive,data.,Using,words,such,as,"seems",or,"appears",implies,subjectivity,on,the,part,of,the,nurse.
A,client,has,been,prescribed,a,narcotic,analgesic,to,be,given,around,the,clock,for,cancer-
related,pain.,The,client,is,competent,and,has,actively,been,involved,in,decisions,regarding,care.,What,sho
uld,the,nurse,do,when,the,client,refuses,the,next,dose,of,pain,medication?
,a),Ensure,that,the,client,understands,the,rationale,for,taking,the,medication.
,b),Document,the,client's,choice,and,reassess,the,pain,in,1,hour.
,c),Ask,the,spouse,to,place,the,medication,in,the,client's,mouth.
,d),Try,to,persuade,the,client,to,take,the,medication,as,ordered,by,the,physician.,ANS,-
B.,Document,the,client's,choice,and,reassess,the,pain,in,1,hour
The,client,has,the,right,to,choose,whether,to,take,the,medication.,The,nurse,should,assess,the,client's,pai
n,on,a,regular,basis,and,educate,the,client,that,taking,the,medication,before,the,pain,gets,out,of,control,w
ill,be,a,better,pain,management,plan.,The,other,options,do,not,reflect,an,understanding,of,the,client's,rig
ht,to,choice,including,the,refusal,of,pain,medication.
, The,nurse,managers,of,a,home,healthcare,office,wish,to,maximize,nurses',freedom,to,characterize,and,re
cord,client,conditions,and,situations,in,the,nurses',own,terms.,Which,of,the,following,documentation,for
mats,is,most,likely,to,promote,this,goal?
,a),Focus,charting.
,b),SOAP,notes.
,c),Narrative,notes.
,d),Charting,by,exception.,ANS,-C.,Narrative,notes.
One,of,the,advantages,of,a,narrative,notes,model,of,documentation,is,that,it,allows,nurses,to,describe,clin
ical,encounters,in,their,own,terms,,as,they,understand,them.,Other,documentation,formats,,such,as,SOAP
,notes,,focus,charting,,and,charting,by,exception,,are,more,rigidly,delineated,and,allow,nurses,less,latitud
e,in,their,documentation.
The,nurse,is,taking,care,of,a,client,who,had,a,laryngectomy,yesterday.,To,assure,client,safety,,the,nurse,sh
ould,give,"hand-off,reports",at,which,of,the,following,times?,Select,all,that,apply.
,a),Change,of,shift.
,b),When,unit,clerk,goes,to,a,staff,meeting.
,c),When,nurse,goes,to,lunch.
,d),Change,of,nurses.
,e),When,new,medication,orders,are,written.,ANS,-A.,Change,of,shift.
C.,When,nurse,goes,to,lunch.
D.,Change,of,nurses.
Effective,communication,is,essential,when,managing,client,safety,and,preventing,errors.,"Handoff,reports
",should,be,made,at,shift,change,,when,there,is,a,change,of,nurses,or,when,the,nurse,leaves,the,unit,,and,
when,the,client,is,discharged,or,transfers,to,another,unit.,There,does,not,need,to,be,a,handoff,report,whe
n,the,unit,clerk,leaves,the,unit,or,when,new,medication,orders,are,written.
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